[Cleft lip and palate: Health-related quality of life (French VSP-A scale) for patients and their family. About 51 families]. / Fentes labio-palatines : qualité de vie (VSP-A) patients et parents. À propos de 51 familles.

PURPOSE, OBJECTIVE: The aim of our study was to investigate the quality of life of patients undergoing cleft lip or cleft lip and palate as well as the perception of quality of life of patients perceived by their parents slot. PATIENTS AND METHODS: Fifty-one adolescents and young adults (29 boys and 22 girls) who underwent cleft lip (FL 22) or lip and palate (CLP 29) and their parents have received psychological and surgical joint consultation. The minimum age for inclusion was 10 years (mean age 15.5 years). A quality of life questionnaire (VSP-A) "children" was given between 10 and 11 years and a questionnaire "adolescents" beyond. Parents have them answered a questionnaire of perceived quality of life of their children. The results were analyzed and compared to a control population (Statistics Student test). Perceived parents lived in relation to their children was obtained through the study of linear regression curves. RESULTS: The response rate to the questionnaires was 66.7% for parents, 85.7% for children and 63.6% for teenagers. The quality of life of the patients was assessed by the patients to 65.1/100 on average. The index of overall quality of life was superimposed on the control population (p=0.66). Perceived quality of life of patients by their parents was fairly close to the quality of life described by patients (66.5). On the areas of family, education, recreation, quality index was proportionately less than for other areas. For each of these areas, parents overestimated the quality of life of their child. Compared to the control group the fields of education, leisure, vitality quality index were significantly lower in the/FL population P.

Knee synovial fluid flow and heat transfer, a power law model.

For the purpose of understanding, the governing system of partial differential equations for synovial fluid flow velocity and temperature distribution in the knee joint has been successfully solved for the first time. Therefore, such an article is shedding light on the convective diffusion of the viscous flow along the articular surfaces of the joints through the introduction of power-law fluids with different features of permeability, and stagnation point flow along a magnetic field. Henceforth, the frictional energy causes the knee joint's temperature to increase. By way of filtration, heated synovial fluid reaches the articular cartilage and provides heat to the bone and cartilage. The lubricant in the joint cavity is properly mixed with this cooled fluid. A rectangular region flow and diffusion model is used to define the issue, thermal diffusion and flow inside the intra-articular gap, as well as flow and thermal diffusion within the porous matrix covering the approaching bones at the joint. Using the similarity solution approach, the linked mixed boundary value problem is addressed. The fluid has been shown to resist moving into or out of the cartilage in certain sick and/or aging synovial joints, causing the temperature to increase. By changing the values of the parameters from their usual levels, it is observed that the temperature did increase in aged and sick joints which impact cartilage and/or synovial fluid degradation.

Magneto-Thermoelastic Response in an Unbounded Medium Containing a Spherical Hole via Multi-Time-Derivative Thermoelasticity Theories.

This article introduces magneto-thermoelastic exchanges in an unbounded medium with a spherical cavity. A refined multi-time-derivative dual-phase-lag thermoelasticity model is applied for this reason. The surface of the spherical hole is considered traction-free and under both constant heating and external magnetic field. A generalized magneto-thermoelastic coupled solution is developed utilizing Laplace's transform. The field variables are shown graphically and examined to demonstrate the impacts of the magnetic field, phase-lags, and other parameters on the field quantities. The present theory is examined to assess its validity including comparison with the existing literature.

Significance of Brinkman and Stokes system conjuncture in human knee joint.

Stokes's equation in the fluid domain and Brinkman's equation in the porous media are combined in the current study which is designated by the Stokes-Brinkman coupling. The current paper gives a theoretical analysis of the Stokes-Brinkman coupling. It has been shown that such a model is a good match for the knee joint. A flow model has been investigated in order to get a better understanding of the convective diffusion of the viscous flow along the articular surfaces between the joints. The Beavers and Joseph slip conditions which are a specific boundary condition for the synovial fluid are used to solve the governing system of partial differential equations for the synovial fluid and the results are provided here. We develop formulas for the interfacial velocity for both flow through special slip condition and analyse the link between the slip parameters [Formula: see text] and [Formula: see text]. Thus, the damping force due to the porous medium naturally when we non-dimensionalize, some parameter which are controlling the structure like, [Formula: see text] and [Formula: see text]. Through the development of an analytical solution and numerical simulation (using the finite volume approach) it is hoped that the mechanisms of nutritional transport into the synovial joint will be better understood. According to the data the average concentration has a negative connection with both the axial distance and the duration spent in the experiment. Many graphs have been utilized to gain understanding into the problem's various characteristics including velocity and concentration, among others. Hyaluronate (HA) is considered to be present in porous cartilage surfaces and the viscosity of synovial fluid fluctuates in response to the amount of HA present.

Non-Newtonian Nano-Fluids in Blasius and Sakiadis Flows Influenced by Magnetic Field.

Current study solves heat transfer and fluid flow problem in Newtonian and non-Newtonian nano-fluids through a permeable surface with a magnetic field effects which is done in the presence of injection and suction for the first time. In order to solve the governing partial differential equations numerically, we used the Runge-Kutta Fehlberg (RKF45) technique in which the similarity transformation method is applied. This approach converts the governing partial differential equations into ordinary differential equations. In this particular investigation nano-particles of copper, copper oxide, titanium dioxide, and aluminium oxide are studied by considering CMC/water as a base fluid with the effect of magnetic field on the classical Blasius and Sakiadis flows of nano-fluids. Validation is carried out using the previously obtained numerical findings. We looked at the power-law index (n), the volume fraction (φ) of nano-particles and the permeability parameter (fw) which affects the flow of nano-fluid and the transfer of heat. Non-Newtonian nano-fluid demonstrates superior performance in terms of heat transfer when compared to Newtonian nano-fluid in both the injection and the impermeable surfaces. Altering the nano-particles' composition, on the other hand, has a far greater impact on the heat transfer process that occurs during suction. Graphics show the impacts of governing physical parameters on Blasius and Sakiadis flow velocity, temperature, skin friction coefficient, and reduced Nusselt number. Physical and engineering interest are explored in detail.

Use of cutaneous flap for continent cystostomy (daoud technique).

PURPOSE: We present the results of a new technique using a pedicled cutaneous flap for continent cystostomy. MATERIALS AND METHODS: A total of 15 boys and 8 girls (mean +/- SD age 13.4 +/- 6.4 years) underwent continent cystostomy for neurogenic bladder (20), bladder exstrophy (2) and sequelae of hypospadias (1) between 1999 and 2008. In this procedure a rectangular pedicled flap is surgically elevated from a hairless area on the abdomen. The flap is tubularized and passed through the anterior abdominal wall directly into the bladder. A submucosal detrusor incision is made to expose the bladder mucosa, and the distal part of the flap is anastomosed to the bladder mucosa in a circular manner. The tube is positioned along the incised detrusor, which is closed over. Viability of the flap, self-catheterization management and continence status are then evaluated. RESULTS: Mean +/- SD followup was 4.5 +/- 3.1 years. There was 1 case of distal necrosis of the flap, which required a secondary surgery using the Mitrofanoff technique. The 22 remaining flaps were initially viable, although 2 patients were eventually lost to followup and 3 subsequently presented with false-passage incidents requiring a few days of calibration using a balloon catheter. Dryness was achieved immediately in 73% of the cases. After adding a complementary bulking agent the dryness rate reached 77%. CONCLUSIONS: We present a novel approach to continent cystostomy that is safe and easy to perform. This technique is a less invasive and more efficient alternative to other commonly used approaches.

Cow's milk allergy related pediatric constipation: appropriate time of milk tolerance.

Cow's milk allergy (CMA) has different clinical presentations according to age. The study aimed to evaluate the extent of CMA as a cause of pediatric constipation and determine the appropriate timing of tolerance to cow milk in such patients. The study included 60 patients suffering from chronic functional constipation, 27 of whom did not respond to 2 month laxative therapy (group I). Thirty age and sex matched apparently healthy infants and children were studied as a control group (group II). Serum specific IgE to cow milk proteins was measured. Withdrawal of cow milk and dairy products for a 1 month period was then followed by cow milk re-challenge over 2 wk. Patients were classified into: responders to this schedule (cow milk allergic=group Ia; n=21) and non-responders (non-cow milk allergic=group Ib; n=6). Eighteen CMA patients continued the study where nine of them underwent milk reinstitution after 6 months and another nine patients after 12 months of elimination. The frequency of CMA among constipated patients was 77.7%. Mean values of serum specific IgE to whole cow milk protein and beta-lactoglobulins were significantly higher in constipated patients (0.82+/-0.08, 0.79+/-0.13 IU/ml, respectively) compared with controls (0.26+/-0.14, 0.27+/-0.14 IU/ml, respectively) and in group Ia (0.99+/-0.08, 0.95+/-0.14 IU/ml, respectively) compared with group Ib (0.39+/-0.06, 0.37+/-0.10 IU/ml, respectively). Serum specific IgE was positive in 85.7% of CMA group, predominantly in class 2. Tolerance to cow milk was achieved after 6 months in only 22.2% compared with 88.8% after 12 months of elimination. In conclusion, CMA is shown to be a significant etiologic factor for constipation in infants and young children. Serum levels of IgE to cow milk proteins are helpful although not definitive for diagnosis. Based on this limited study, tolerance is better achieved after 12 months of strict cow's milk elimination.

Complexity trees of the sequence of some nonahedral graphs generated by triangle.

Calculating the number of spanning trees of a graph is one of the widely studied graph problems since the Pioneer Gustav Kirchhoff (1847). In this work, using knowledge of difference equations we drive the explicit formulas for the number of spanning trees in the sequence of some Nonahedral (nine faced polyhedral) graphs generated by triangle using electrically equivalent transformations and rules of the weighted generating function. Finally, we evaluate the entropy of graphs in this manuscript with different studied graphs with an average degree being 4, 5 and 6.

A laser pulse impactful on a half-space using the modified TPL G-N models.

This article aims to investigate the wave propagation of generalized thermoelastic half-plane under the effect of thermal loading due to laser pulse with and without energy dissipation. The normal mode method is proposed to solve the problem and get numerical results for the field quantities. The outcomes of the physical quantities have been illustrated graphically and reported to compare the simple Green-Naghdi II and III and their modified single-, dual-, and three-phase-lag models. The graphical outcomes indicate that the different types of Green-Naghdi models with thermal relaxations have great effects on the temperature, displacements, dilatation and stresses.

The protective effect of a purified extract of Withania somnifera against doxorubicin-induced cardiac toxicity in rats.

The therapeutic value of doxorubicin as an effective antineoplastic agent is limited by its cardiotoxic side-effects. The administration of doxorubicin (10 mg/kg) to male Wistar rats induced necrosis and apoptosis in heart tissues. It also caused oxidative stress damage as evidenced by the elevation of malondialdehyde and protein carbonyl levels and catalase activity, accompanied by the concurrent depletion of total antioxidant capacity and of superoxide dismutase level in cardiac tissues. The doxorubicin-induced cardiotoxicity and oxidative stress damage were also accompanied by increases of myeloperoxidase activity, total calcium content, and the expression of Bcl-2 protein in heart tissues. Most of these doxorubicin-induced biochemical and histological alterations were effectively attenuated by prior administration of purified standardized extract (1.5% withanolides; manufactured by Idea Sphere Inc., American Fork, UT, USA) of Withania somnifera (300 mg/kg). Thus, Withania may play a role in the protection against cardiotoxicity and thus might be a useful adjuvant therapy where doxorubicin is the cancer-treating drug.

[Dual kidney transplant: the E. Herriot Hospital Lyon experience]. / Bitransplantation rénale : expérience du protocole lyonnais de l'hôpital E.-Herriot.

INTRODUCTION: In the current context of a high incidence end-stage kidney disease and a shortage of organs for kidney transplantation, the increasing use of transplants considered to be "borderline" represents a potential source of transplants. Over the last 10 years, some centers have developed a transplantation strategy, which consists of transplanting two borderline kidneys that cannot be proposed separately in a single recipient. The authors report their experience of dual kidney transplant. MATERIALS AND METHODS: Since 2001, 15 dual kidney transplants have been performed in a single centre according to a local protocol based on the correspondence between the weight of the donor kidney and the recipient's weight, weighted by the number of fibrotic glomeruli observed on the initial biopsy. In this study, the authors analyze the postoperative complications and functional results observed in patients transplanted according to this protocol. RESULTS: Dual kidney transplants represented less than 5% of all transplants performed during the study period concerned, which remained lower than the objectives initially announced by the ABM. The surgical technique was left to the surgeon's discretion. The mean follow-up was 26.3 months. Fourteen of the 15 recipients were alive with a functional graft. Surgical complications were globally more frequent when kidneys were transplanted on the same side (versus transplanted on both sides). Mean serum creatinine was 119.4 mol/l at six months (creatinine clearance according to MDRD formula: 57.3 ml/min per 1.73 m2), 118.8 mol/l at 12 months (creatinine clearance: 55.8) and 132.4 mol/l at 24 months (creatinine clearance: 44.2). One year post-transplant, mean renal function measured by inulin clearance was 55.5 ml/min per 1.73 m2. Four of the 15 patients had experienced an episode of acute rejection and three patients experienced delayed return of transplant function. CONCLUSION: In view of the results obtained, the authors consider that dual kidney transplant could be a reasonable and effective option for selected patients. Positioning of the transplants in each iliac fossa limited the surgical complication rate.

Modulation of doxorubicin resistance by valinomycin (NSC 122023) and liposomal valinomycin in Chinese hamster ovary cells.

Recently, we have reported that the toxicity of the membrane-active agent valinomycin (VM) can be reduced with maintenance and/or enhancement of its antitumor activity by incorporation in liposomes (S. S. Daoud and Juliano, Cancer Res., 46:5518-5525, 1986). Since the underlying defect(s) in multidrug resistance reside mainly in the cell membrane, it seems reasonable to attempt to overcome multidrug resistance with membrane-active drugs. Here, we report on the in vitro restoration of Adriamycin (ADR) sensitivity in a resistant Chinese hamster ovary cell line (CHRC5) by treatment with nontoxic doses of valinomycin or of liposomal valinomycin. During a 1-h drug exposure, the sensitivity of CHRC5 to ADR was enhanced 21- to 28-fold when 20 or 40 nM VM was present, doses which are not toxic to CHRC5 cells. At the same time, modest synergistic toxicity could be seen in the parent drug-sensitive cell line (AUX B1). At 100 nM VM, the sensitivity of CHRC5 to ADR was restored to almost that of the sensitive AUX B1 cells. The effects of liposomal VM on ADR sensitivity were similar to the effects produced by free VM. At nontoxic doses and with continuous exposure of the drug, valinomycin was highly active in restoring ADR sensitivity in CHRC5 cells. In cells treated for 72 h, valinomycin enhanced the sensitivity to ADR 208- to 250-fold in CHRC5 and 3- to 5-fold in AUX B1 cells. Measurements of ADR uptake and efflux indicate that, unlike other multidrug resistance modifiers, valinomycin exerts its actions in modulating ADR resistance by mechanism(s) other than increasing intracellular accumulation of Adriamycin. The possible mechanisms of the restoration of ADR sensitivity by valinomycin are discussed.

Reduced toxicity and enhanced antitumor effects in mice of the ionophoric drug valinomycin when incorporated in liposomes.

Valinomycin (NSC 122023) is a cyclic depsipeptide antibiotic with potassium selective ionophoric activity. This drug has been reported to display antitumor effects but its utilization has been limited by its extreme toxicity. Here we report that the incorporation of valinomycin into multilamellar liposomes composed of dimyristoyl phosphatidyl choline:cholesterol:phosphatidyl serine (10:4:1 M ratio) results in a profound reduction in toxicity with maintainence of antitumor efficacy. Thus the median lethal dose (LD50) for i.p. administered valinomycin (VM) in C57BL/6 X DBA/2 mice is 1.7 mg/kg whereas the LD50 for liposome incorporated valinomycin (MVL-VM) is in excess of 50 mg/kg. In like manner, the LD50 for i.v. administered VM is 0.18 mg/kg where the LD50 for MLV-VM preparations passed through a 0.6-micron filter is greater than 10 mg/kg. The antitumor efficacies of i.p. administered VM or MLV-VM against i.p. P388 mouse leukemia were similar in multiple dose formats using doses below the maximal tolerated dose for VM. However, since MLV-VM was substantially less toxic than VM, the liposomal drug also produced significant (170% median survival time of treated mice/median survival time of untreated control) antitumor effects when administered as a single dose at levels above the maximal tolerated dose for free VM; single doses of free VM at the maximal tolerated dose were ineffective in this context. In experiments with i.v. inoculated P388 leukemia, MLV-VM but not free VM, displayed antitumor activity (144% median survival time of treated mice/median survival time of untreated control) when administered i.v. at equitoxic doses. Thus the use of a lipid vesicle drug carrier system permits a reduction in the toxicity of valinomycin with maintainence or enhancement of antitumor activity against i.p. or i.v. P388 leukemia.

Morbidity and nutrition patterns of three nomadic pastoralist communities of Chad.

As a part of an interdisciplinary research and action programme, morbidity and nutritional patterns were assessed in three nomadic communities: Fulani and Arab cattle breeders and Arab camel breeders, of two prefectures in Chad. The predominant morbidity pattern of Chadian nomadic pastoralists (representing approximately 10% of the total population of the country) had not been documented so far. A total of 1092 women, men and children was examined by a physician and interviewed during two surveys in the dry season and one in the wet season (1999--2000). Participants with no complaint were rare. Pulmonary disorders (e.g. bronchitis) were most often diagnosed for children under 5 years of age. Of the adult participants, 4.6% were suspected of tuberculosis. Febrile diarrhoea occurred more often during the wet season when access to clean drinking water was precarious. Malaria was only rarely clinically diagnosed among Arabs during the dry season, whereas Fulani, who stayed in the vicinity of Lake Chad, were also affected during this period. A 24-h dietary recall showed that less Arab women than men consumed milk during the dry season (66% versus 92%). Malnutrition was only documented for 3 out of 328 children (0--14 years). Arab women in childbearing age had a higher proportion of children not surviving when compared to Fulani women (0.2 versus 0.07). This study identified several implications for reseach and interventions in nomadic settings. Innovative and integrated health services for nomads can possibly be extended to many settings as nomadic pastoralists have in common a similar way of life driven by the needs of their animals.

[Mediastinal localisation of a thoracic duct lymphocele--account of a surgical case]. / Localisation médiastinale d'une lymphocèle du canal thoracique: apropos d'un cas opéré.

INTRODUCTION: Lymphocele of the thoracic duct is a rare pathological entity occurring as a consequence of deterioration and cystic dilation wall of this vessel. It may be of congenital or degenerative origin. OBSERVATION: We report the case of a 47 year old patient, operated on for a symptomatic cyst localised by CT scan to the inferoposterior mediastinum. At postero-lateral thoracotomy it was identified as a lymphocele and completely resected. Chemical analysis of the liquid and histopathology study of the cystic wall confirmed the diagnosis. The patient's post operative course was uneventful. CONCLUSION: This case demonstrates the clinical characteristics of this entity and describes diagnostic techniques and surgical management.

[Percutaneous rotational osteoclasis in management of congenital radio-ulnar synostosis]. / Ostéotomies percutanées de dérotation de l'avant-bras dans les synostoses radio-ulnaires congénitales de l'enfant.

PURPOSE OF THE STUDY: Congenital radio-ulnar synostosis blocks the wrist in a position of more or less pronounced pronation. The degree of pronation and possible bilateral involvement can compromise upper limb function. We propose percutaneous osteoclasis of the antebrachial skeleton to remedy this situation PATIENTS AND METHODS: We performed 12 percutaneous rotation osteoclasis procedures. The objective was to weaken the metaphysodiaphyseal cortical periosteum of one or both of the forearm bones by intermittent perforations. This enabled derotation of the wrist which was maintained for six to eight weeks in a brachiopalmar cast. RESULTS: Mean correction of pronation was 51 degrees. There were no cases of vascular or nervous complications and healing was uneventful. The esthetic outcome was very satisfactory. DISCUSSION: Surgery is not indicated for all cases of synostosis. We retain for surgery patients presenting pronation at 60 degrees or more. At this degree of pronation, function is greatly compromised in adolescence, particularly if there is a bilateral involvement. Compared with other techniques, percutaneous osteoclasis is a simple safe and reliable technique. Reoperation is not required to remove material. The procedure is easier in young children, preferably at the age of 3 to 7 years, before the development of a functional handicap.

[Management of Lagrange and Rigault stage IV extension type supracondylar fracture of the humerus in children]. / Prise en charge des fractures supracondyliennes en extension stade IV de Lagrange et Rigault.

PURPOSE OF THE STUDY: Lagrange and Rigault stage IV extension type supracondylar fracture of the humerus (Gartland and Wilkins type III) involves major displacement, making treatment difficult. Several therapeutic methods have been described but indications vary considerably between teams. We conducted a retrospective analysis in order to evaluate the results of different methods, identify the most adapted technique, and detail the conditions necessary for good results with the collar and cuff immobilization method described by Blount. MATERIAL AND METHODS: Forty-four children (30 boys and 14 girls), mean age seven years six months, were treated between January 1990 and December 2001. The collar and cuff immobilization technique was used for sixteen children (including four who underwent open revision for early secondary displacement), percutaneous pinning for two, and open crossed pinning for thirty (including four who developed secondary displacement after collar and cuff immobilization). One out of two collar and cuff treatments was instituted within six hours of injury. The four secondary displacements after collar and cuff immobilization treatment occurred after fracture reduction more than six hours after injury. The proportion of open reductions increased with longer delay to reduction after injury. Mean immobilization was three and a half weeks. The Flynn criteria were used to assess outcome at mean seven years eight months follow-up. RESULTS: Outcome was satisfactory in all children treated with definitive collar and cuff immobilization and by percutaneous pinning; the rate was 97% after open procedures (persistent sequelae of radial palsy in one child). DISCUSSION: Early treatment before six hours increased the chances of success with the collar and cuff method which remains the technique of choice for Lagrange and Rigault stage IV extension type supracondylar fractures. In the event of failure or complications, other classical methods should be discussed, including percutaneous pinning or direct access for open osteosynthesis.